title: Acute hepatic injury after the withdrawal of immunosuppressive chemotherapy in patients with hepatitis B.
abstract: Five patients with lymphoproliferative malignancies and chronic hepatitis B suffered severe acute hepatic injury after the withdrawal of multiagent chemotherapy that included high-dose corticosteroid. Four patients died of hepatic failure, three of whom received corticosteroid as treatment for the hepatic injury. We believe that the cause of this entity is massive immune-associated cytolysis of hepatitis B virus infected hepatocytes occurring after a period of immunosuppression and increased viral replication. The literature regarding this complication of chemotherapy and its pathophysiology is reviewed.
authors.affiliation: Department of Medicine, Los Angeles County University of Southern California Medical Center.
authors.forename: P C
authors.initials: PC
authors.lastname: Pinto
authors.forename: E
authors.initials: E
authors.lastname: Hu
authors.forename: M
authors.initials: M
authors.lastname: Bernstein-Singer
authors.forename: L
authors.initials: L
authors.lastname: Pinter-Brown
authors.forename: S
authors.initials: S
authors.lastname: Govindarajan
mesh_terms: D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002908:Chronic Disease; D005260:Female; D006509:Hepatitis B / Q000150:complications* / Q000201:enzymology / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000032:analysis; D006689:Hodgkin Disease / Q000150:complications / Q000188:drug therapy* / Q000201:enzymology; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000150:complications / Q000188:drug therapy* / Q000201:enzymology; D008099:Liver / Q000187:drug effects*; D008111:Liver Function Tests; D008223:Lymphoma / Q000150:complications / Q000188:drug therapy* / Q000201:enzymology; D008228:Lymphoma, Non-Hodgkin / Q000150:complications / Q000188:drug therapy* / Q000201:enzymology; D008297:Male; D008875:Middle Aged; D011241:Prednisone / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D006514:Hepatitis B Surface Antigens; D011241:Prednisone